369 - The Profit Center That Helps You Get Better Results

[00:00:00] The problem is we were designed to be barefoot on grass and rocks and sand our whole lives, right? So we were designed to get an incredible amount of feedback from our feet. Our brains evolved with that for millions of years. And none of us get that. And over time, our feet become weak and dysfunctional from wearing modern shoes and walking on flat surfaces. So the reality is almost everybody is getting faulty information from their feet. So now instead of this, what if your brain thinks one foot's going this way and one foot's going that way?

[00:00:27] Now you've got half your body trying to go this way and half your body trying to go that way.

[00:00:41] Hello and welcome to The Remarkable CEO Podcast, a show dedicated to chiropractors who want to transform their job into a business so that they can have a remarkable practice as part of a remarkable life, not instead of one. With your hosts, Dr. Pete Camiolo and Dr. Stephen Franson.

[00:01:05] Hi, everyone. We've got Dr. Andrew Powell from Better Balance Orthotics, an amazing product out of Australia here. So welcome, Dr. Andrew. Thanks, Malcolm. Thanks for having me. Yeah. So I know with Better Balance Orthotics, there's a bit of a story behind it of how you came across them in the first place and why you see it as such a vital tool in helping people's nervous system as we do as chiropractors. So you can tell a bit of the story behind it.

[00:01:31] Yeah, absolutely. I mean, that's really what it's all about for us is helping the nervous system. And so, you know, I guess a bit of background for myself. I grew up my whole life with really flat feet. I didn't realize at the time just how damaging that was.

[00:01:44] As a kid, I was the goalie on my soccer team for 10 years because I couldn't run. Ultimately, I ended up with bilateral hip degeneration, a completely destroyed L5 disc and an abdominal hernia. All things which at the time I didn't know, but now I've realized all of those came from my gait. They came from the mechanics that came from my fit.

[00:02:01] So when I got into practice as a chiropractor, I did start exploring traditional orthotics. I used a number of different companies over a number of different years. And basically, I came to the conclusion they're all crap. I realized that none of them worked. I wasn't seeing the results that I wanted for my patients or for myself.

[00:02:20] What I've since come to realize is that they're basically a mechanical crutch. They don't change neurology. They don't change long-term outcomes. They basically just push the foot into a different shape. But the way I explain it to my patients, I say it's like if you came to me with back pain and I said, here, just wear this back brace every day, you'll be fine. You might feel better with the back brace to begin with, but over time, is your back going to get weaker or stronger?

[00:02:43] Yeah. And as chiropractors, we know it's going to get weaker. Every patient gets that question right. I say, yeah, it's going to get weaker, right? The brace is doing the job that my back should be doing. And the same thing is true for a traditional orthotic. So when I was introduced to these through a mentor of mine, he said, if I was ever going to use any orthotic, this is the only orthotic in the world I would ever use. And that was interesting to me. This was my first applied kinesiology teacher, someone who really changed the course of my career and who I have a lot of respect for.

[00:03:13] So I listened. So I went and sought out, they were actually developed by a medical doctor here in Sydney named Dr. Ed Butterworth. And his passion was scoliosis. He had a daughter with a very bad scoliosis. She had a failed Harrington rod surgery. And he was looking for answers. He was looking for a way to treat scoliosis. And he came across this concept out of France and Italy. There's a discipline over there called posturology. And they were really researching how inputs in the feet can change the spine.

[00:03:43] And I developed his version of that, which looks like this thing right here. You can see very thin, very flexible, no arch supports, right? They're purely about stimulating proprioception. The only thing was, Ed was in medical practice. And this was like a tiny little hobby for him. He was hard to find. I had to search him out. He was working in Circular Quay in the city. The only way I could actually get to him was to go and see him as a patient and have a conversation with him.

[00:04:10] So I did that. And I took on his orthotics and started using them in the clinic. And probably for the first five years that I used them, all I did was use them to treat scoliosis. Because that was my understanding at the time. They do create some incredible outcomes for scoliosis. He had a ton of before and after x-rays. He'd really been working on this, you know, photos, all that kind of stuff. He'd been working on this for a number of years by that point.

[00:04:33] So what started to happen over time is we started to see changes in much more than scoliosis. And so we started to kind of use these more and more. But first of all, obvious things are, what about foot problems? What about plantar fasciitis? And then, you know, what about dodgy knees? Maybe they'll help those things. Over time, we found more and more and more things resolving when we started putting these on people's feet. Yeah. So it started from the posturology, was it called, in France? It's in Italy, yeah.

[00:05:01] Yeah. And they already had the theory at that point in time that changing the feet, because I know this and you know this to be true, that it actually changes the way the muscles work right up through the whole body. So they were onto that at that point in time. And then he developed these from that. And it's still the same now as it was back then, what he developed? Pretty much, yeah. They've gone through one iteration, one update, but they're pretty much the same.

[00:05:25] So they have a whole bunch of research in French and Italian, which I've looked at, but I don't speak either of those languages, which is fair enough. But since then, what happened is that Dr. Ed sadly passed away in 2020. And before he did, he came to me and said he was in his 80s and he had some health problems. And he said, I want to retire. I know I've got this life changing, this world changing, actually. He said, I know I've got a product that can change the world, but I've just never had time in my medical practice to take it out to the world.

[00:05:53] And I want someone who's going to do that. And I think maybe you're the person to do that. So that kind of, to be honest, I didn't actually really want to take that on. I was busy, you know, running a busy practice. I have a young family, all that kind of stuff. But I knew that if I didn't do it, nobody else was going to. And the world was going to lose something really valuable because he was right at the time. I didn't see my vision wasn't as big as his.

[00:06:17] But since then, I've just dived down the rabbit hole of research and of measurement of different testing modalities. You know, I write a newsletter every week. I'm always studying. Why do these things make such a huge difference to a person's nervous system? And it turns out there is lots of research around it, just in different ways. You know, the last five years have been a real deep dive into understanding just how profoundly our feet really do affect

[00:06:43] our whole neurology, our brain, our pelvic floor, our core muscle activation. Just even, you know, these days we're getting to things like blind spot mapping and all sorts of neurological measures, cerebellar tests, vestibular tests, all sorts of things that change when you change the input to the feet. Yeah, that's amazing that when I know that scoliosis, we know that that is a stubborn area for chiropractic practice, isn't it? You know, what is the best way to manage someone with a scoliosis?

[00:07:12] So just if we start with that one, and then we can get into all the other problems that you have solved from a patient point of view in the practice. So things that the people may not have even thought of their feet about, you could do something like this. So with the scoliosis, what sort of outcomes are getting from this? Because it started from that, and this is what Dr Butterworth was doing. What sort of changes in scoliosis do people get with this? Many people get quite a degree of straightening.

[00:07:41] We measure posture and we see changes in posture every time, to be honest. Scoliosis is a little more variable. And it's the first thing I would do in any scoliosis care plan. I co-manage some people who also choose to go down the route of bracing and that kind of thing. But I think these are a really vital part of it. And, you know, I went to a seminar on scoliosis a few years ago, and they said we never used to understand.

[00:08:07] Like when I was studying, as I'm sure when you were, they used to call it like adult idiopathic scoliosis, right? It's basically the name says we don't know how it... We don't know how it happened. We don't know how to fix it. Yes. Yep. We don't know where it came from. And I went to this seminar and they said, oh, that's not the case anymore. We've figured out scoliosis. I went, oh, this is great. I can't wait to hear it. And they said, we've figured out it's an imbalance in the growth plates, right? One growth plate is growing more or less than the other growth plates in the vertebra.

[00:08:36] And over time, the vertebra starts to become wedged. And that's what creates the spine and then creates the curve. And then everything compensates. And I went, you haven't figured it out. That's the mechanism. But why does that happen? Right? Why does it happen? Why? And they didn't know. They had no why. I went, okay, maybe you figured out something, but it doesn't explain it. In my experience, there's a few factors, right? The TMJ I find also is really important for scoliosis. But the way I explain it to my patients, I say, look, if you're standing on flat level

[00:09:05] ground, let's say now you're standing on the side of a hill. So your feet are like this. So your brain knows it's got to fire the muscles down one side of your body and relax the muscles down the other side so you don't fall down the hill. So your brain is constantly setting up your posture based on the input and the feedback it's getting from your feet. The problem is we were designed to be barefoot on grass and rocks and sand our whole lives, right? So we were designed to get an incredible amount of feedback from our feet. Our brains evolved with that for millions of years. And none of us get that.

[00:09:34] And over time, our feet become weak and dysfunctional from wearing modern shoes and walking on flat surfaces. So the reality is almost everybody is getting faulty information from their feet. So now instead of this, what if your brain thinks one foot's going this way and one foot's going that way? Now you've got half your body trying to go this way and half your body trying to go that way. And I actually think, and this is my opinion, this is not, you know, I don't have research

[00:09:59] on this, but it makes sense to me that that is one of the logical drivers of this imbalance that we're talking about that ultimately sets someone down a path of scoliosis. Yeah. Okay. So there's, and you've seen results in the practice for practice members that some of them, it has, as you said, postural changes you see all the time with people. So that's, I presume that's like forward head posture. That could be hypolidosis, hypolidosis, that sort of thing. You see that pretty much with everyone. All of those.

[00:10:28] I see really like currently, I see shoulder heights, mastoids, everything even up. I see those scapulas even up and that's where I see the spinal curve. I have a picture of my son when he was about eight. He'd only ever worn barefoot shoes. But one day I looked at him and he had this classic posture, right? The two big signs, forward head posture and a forward translation of the pelvic, right? Pelvis sometimes with a tilt, sometimes without it. And if you start looking, you'll see this in all of your patients to a greater or lesser extent.

[00:10:57] But he also had really offset scapulars. I look at that and I just see a scoliosis in development, right? He wasn't quite at that age where it really takes off, but he already had, he was set up for it. And so I think we're just seeing a more advanced version of that because we do see straightening. We see x-ray changes. We see straightening of scoliosis. We see stopping of progression. Again, the results are variable. Some people, it's like, it's dramatic. Other people, less so.

[00:11:26] But it's, like I said, it's the first thing I would do in any scoliosis case, for sure. Is to check that out because that is something that, I mean, this is a unique product worldwide in that no one else is looking at it from this point of view, are they? Of stimulation through the feet to work. And if you're, correct, you know, if you're bracing, which I'm not against, but if the problem is coming from the feet and you haven't addressed the feet, you're still fighting against that impulse every time. And the same is true with so many traditional support strategies, right?

[00:11:55] These, we're working with the body. We're actually correcting the input that's driving the dysfunction rather than just trying to support that dysfunction mechanically. Yeah. Just on that, I know that you said that you had used other orthotics and, which is really trying to correct the foot as a crutch, so to speak, not so much to stimulate. So you can talk a little bit more about that, about how traditional ones, what the main difference is here.

[00:12:21] So the difference, we call it the stimulation versus support paradigm, right? The difference is fundamentally a completely different approach. A traditional orthotic is an arch support, basically, and they all have their own little, you know, ours is softer, ours is harder, ours has a metatarsal dome, ours doesn't, ours has this funky little thing. But they're all the same paradigm. They are all basically pushing the foot into a different shape. And I've tested thousands of patients now.

[00:12:50] And, you know, you've seen this demonstration live. I tell you. Where we'll stand a patient on orthotics, right? Instant changes. They don't need to wear them for weeks. It's instant, right? When they stand on it, different muscles activate. Range of motion changes. Palpation changes. Neurological tests change. So often, people come up to me, chiropractors at a seminar, and they go, I'm really interested to see this. They go, hey, I've got my foot levelers in my shoes right now. And I'm not picking up foot levelers. They're just the most common ones you come across. Yeah. They go, great.

[00:13:20] Let's do the test. And they don't make those same changes, right? They might be, sometimes they'll say, hey, these help me with my back pain and all of that. And I say this because if you've got a broken leg, you need a crutch, right? There's nothing wrong with using a crutch. The problem is if you think it's going to fix the problem. Because it's not. It's just supporting the problem. And so, you know, I talked before about my flat arches that I grew up with. I have more or less perfect arches in my feet now. I didn't have those for more than 30 years of my life when they were walking on the beach.

[00:13:50] My wife, yeah, my wife Jodie said, hey, look at your footprint. It's like, she's like, it looks like a foot now because it used to just look like a blob. They straighten up people's bunions, right? Which I've never seen. So they make lasting structural changes. I say to patients, look, this is not, you know, that's a crutch. This is a rehab device. This is actually training your body to do the work. So it's not only that it changes the neurology immediately, but it changes the structure itself in a long-term way, the body adapts, that we basically start undoing the compensation

[00:14:18] patterns that have come from a life of walking on flat, neurologically boring surfaces. Yeah, because, I mean, that's life now, isn't it? As you said, we were designed to walk on sand and rocks and to accommodate those surfaces, which we don't get because we're walking on artificial surfaces 99.9% of the time, probably. There's that side of it as well. Hey doc, Steven Franzen here. If you're like me, you know that we're in the business of saving lives.

[00:14:47] And when business is good, everybody wins. That's the good news. But here's the bad news. Most chiropractors don't own a business at all. They own a job. It's a job they love, but it's a job. And far too often, it feels like that job owns them. Is this true for you? Do you own a business or a job? Have you built and do you run your practice on brute force? Does it rely fully on your time, your effort, a pound of your flesh?

[00:15:17] Are you responsible for all growth, for all new patient generation? How about new patient conversions? Is it all up to you? How about patient care and delivery? Are you a sole practitioner, an owner-operator who owns the practice, but is also the only one that is head down and bum up, taking care of all the patients? Is revenue generation or collections all up to you? Let me ask you the most telling question. Doc, what would happen if you took 90 days off? What breaks?

[00:15:48] In my experience, most on-purpose chiropractors do not lay awake at night worrying about their practice. They worry about their business. Let's slay that dragon. The Remarkable CEO program has helped hundreds of chiropractors, just like you, turn the job that they love into the business that they've always wanted. Are you ready to run and build your practice on leverage instead of brute force? Do you want to create the scalability and durability that will allow you to make a bigger impact and a bigger income?

[00:16:16] What would it mean to grow your practice, increase your productivity, and your profitability? Do you want to get your time freedom back? Are you ready to turn your pirate ship into a battleship? If this sounds like you, then the Remarkable CEO program is for you. Just last year, 53 of our Remarkable clients received the 7-Figure Club Award, meaning they hit the million-dollar mark for the first time or their next million-dollar level. Be it 2 million, 3 million, 10 million, up to 36 million and growing.

[00:16:46] Now, Doc, is it crazy to imagine that your practice could be next? Click the link below and learn how to apply for the next cohort of the Remarkable CEO program. We look forward to working closely with you in creating the business that supports your Remarkable life, not competes with it. So the one thing I wanted to, you just mentioned before about how you went down the rabbit hole and looking at all the different things.

[00:17:10] And just talk about some of those other things that you have seen and what you're tracking and what you've found with using this. And the fact that it's actually stimulating the nervous system in a different way. Yeah, absolutely. So one of the things that I've really come to explore is the fascial system. If you look at, it's become a huge textbook in my life, Anatomy Trains, by Tom Myers, which talks about the fascial, myofactual meridians. So these are tracts where muscles and fascia integrate.

[00:17:40] And it takes us from thinking about structure in terms of an individual muscle firing to thinking about how does the body actually transmit force? Right. Every time you strike the ground, you've got to absorb that ground reaction force. And every time you tow off, you've got to actually give that force back to the ground to propel you forwards. And we have this incredible mechanism where when we strike the ground, our heel strikes with about 1.5 times our body weight. But by the time we tow off, we actually tow off with about 2.5 times our body weight and force.

[00:18:10] So we actually absorb the force, or at least we're supposed to if we're working properly. We use the contractile and the tensile issues of our fascia to actually multiply that force. And then we give it back to the ground. So the same thing is true. You know, if someone pushes on me, that force has to go somewhere. I have to absorb that force. And it ultimately has to anchor out through the ground. Otherwise, I'm going to fall over. Yeah. So these fascial trains really are how our body translates force into movement.

[00:18:40] And apart from what are called the arm lines, all of the fascial meridians begin on the feet and end on the head. They're the organizing principle of our posture. So my first lens for understanding the orthotics was neurology. I worked with a chiropractic neurologist. I said to him, because he said, I think you'll find everybody actually needs these. Once you clear up some of these other things, everyone needs them. And at the time, I really struggled with that. I said, look, if we understand innate, how can everyone need them? Like that doesn't make sense. Right. When does it go wrong?

[00:19:10] And he said, I don't think it ever goes wrong. I think it just never goes right. Right. From the very first day we start walking, we never receive the amount of afferent information from our feet that we were designed for. And our brain is just missing. You know, there's deaffrontation in the brain. It's not getting the input. And so he's right. Right. And so that's the first model is neurological. But then on top of that, when we really start to understand the fascial system and how force is translated in the body.

[00:19:37] For instance, there's research that's been done that shows that when you contract intrinsic muscles of your feet, there's a reflexive contraction of the pelvic floor. But it doesn't go the other way. Right. If you squeeze your pelvic floor, it doesn't activate your feet. But if you squeeze your feet, it activates pelvic floor. And it makes sense. Right. Because what's the point of having a strong core if you're not anchored to the ground? Right. So when you activate pelvic floor, you want the ground to be, you know, so there's all these mechanisms.

[00:20:04] When I started to look at that, I'm like, man, this is my low back patients. This is all my neck patients. This basically, any spinal subluxation pattern that you choose, I can these days really relate directly to the feet and what's going on there. It's, I never thought I'd be a foot guy, right? It's not, I didn't set out to be the foot guy. It was never a particular area of interest for me. And yet, the more I study the research and the more I look into it, the more I can see

[00:20:30] that almost everything through a clinical window relates back to the feet. Yeah. I mean, it's, it is the foundation of the whole body. So it makes sense. So you mentioned before about how changing some brain function to do with like eye tracking, I think you said, or what was the other things you were looking at? Eye tracking is one I haven't looked at yet. This was one that it was blind spot mapping, right? A lot of the chiropractic neuro guys, they, when your blind spots are even, that's an indicator

[00:20:58] that both sides of your brain are even in their output. When they're uneven, then you've got an imbalance. If you, and you can map it, you can draw it out pretty easily. I had one of our practitioners who was studying the carrot course. And he said, I've been doing everything to get my blind spots even and nothing had got there. And then as soon as I put these on my shoe, like in my shoes, my blind spots even, right? So left and right brain evened out. Just at the last TRP event, I was talking to David from CLA. I just purchased an insight scanner.

[00:21:26] I'm going to start using the HRV and all of that just as another, we've got a whole bunch of measures, but another measure to start to show changes. When you look at the neurology, a lot of our autonomic neurology is actually enmeshed in our fascia. Fascia has, I can't remember the number, but it's like hundreds of percent more nerves in the fascia than there are in the muscles. They say the brain listens to the fascia and talks to the muscles. So when we start to change that, I think we're going to see big HRV changes because I've

[00:21:55] seen quite a number of people who said, hey, my URA score, like my URA ring sleep score improves 20 points when I wear these and goes down 20 points when I don't wear them. So more and more, we're discovering different outcome measures that I usually go would never ever have thought had anything to do with the feet. And yet evidence is stacking up. Well, it's, it's, um, I mean, at the core of it, you're a chiropractor and what you found is that it does help people to hold their adjustments better or however you want to put it. You've noticed that.

[00:22:25] And you're seeing the brain changes in people, as you said, like that case study of one with the, with the blind spots, put them in and go, well, that works. So, you know, you're having an impact on the way the brain works. Absolutely. Yeah. And it's all, I just, it's funny. I write a weekly newsletter and my one that just came out, days that came out on Sunday was titled, can you prove that people hold their adjustments better? And that's exactly what it was about. You know, I know Steve Frenzler talks a lot about like keeping the main thing, the main thing, right?

[00:22:53] It's got to relate back to the adjustment and he's right. The way we frame it for our patients is look, um, these are going to help you to hold your adjustments better and they're going to help you make the most out of every adjustment. Now, how do we know that's true? Because we measure it. We actually track it, right? And we, we use a vestibular plate. We use postural photos. We use thermal imagery. We're about to start using the insight. We track this whole lot of different objective measures. And what you see is that people actually hold their adjustments better. They need less correction.

[00:23:23] And because there's two things that can happen. Sometimes you've got that subluxation that just keeps coming back. Or sometimes you correct it. And then the next, then the knee blows out of some other spot in the spine. And you realize that what you're doing is shifting stress around in the biomechanical chain, but it can take some time to resolve it all. And the reason I've come to understand is because we all have a different, we know that subluxation basically is caused by stress, right? Structural, chemical, or emotional.

[00:23:51] We all have different emotional stresses in our lives. We have different chemical stresses. We eat different diets. We do different things. But there's one stress that everyone I know has in common. And it's the fact that we all wear shoes and we all walk on these flat, unnatural surfaces. Yeah. So I really see that if I'm allowing a patient to walk, to step off my treatment table and walk out without addressing this in their feet, I'm pushing it uphill. In fact, I actually used your analogy of Sisyphus from the weekend to talk about,

[00:24:20] you know, you talked about if you're always having to put energy in, push the bolver uphill in terms of the systems in your practice. But the same is actually true on a clinical level. If you take this stress out of it, you lower the hill that you're trying to push up to get your clinical results as well as the systems in your practice. Yeah. I often use the analogy of, I use this for migraines, but it's for anything in chiropractic. It's like you've got a bucket and different stresses you're putting into that. And if those stresses overflow,

[00:24:48] then you start to get functional loss and so forth in there. So if someone's getting off their chiropractic table and there's a stress straight on there, the bucket is, there's already something in it. The second they get off the table is what you're saying. So they're almost straight away going to be in some sort of functional adaptation process because of what's happening with their feet. Yep. And that stress continues every minute they stand, every time they walk or run.

[00:25:14] So they're working against you all the time, unfortunately. Okay. I wanted to spend some time because we have a lot of listeners, we have a lot of people who they're looking for other ways to expand their, obviously their clinical outcomes, but looking at the other side of the coin from the business side of you, because that's really important for chiropractors as well. So you can explain to me how that side of it works and what you've noticed in practices who do incorporate this part of it,

[00:25:43] because the practice systems is driving impact to the people in the practice. We've been over that for the last 20 minutes. What about the business side, the income, the revenue, how does this benefit them as a practice, if you like? There is a clear benefit, right? Obviously, so there's a good markup on the orthotics so that they're a stream of revenue for the practice. And there's lots of ways that you can do that. But the way this has really found the system that we've found to work best clinically,

[00:26:12] because for me, I want the best clinical outcomes and the best practice, like the how to be married together, right? As you said, there has to be integrity and alignment there. And this, like you said, we've talked about it delivers on the clinical. So I used to just prescribe them every now and then. And then I went, these are so important, I have to start checking everybody. I started putting them in at my progress exam going, I'll do some adjusting first, and then I'll get these on their feet to deal with whatever's left. It made sense to me at the time.

[00:26:40] But then I realised they're working against their adjustment from the minute they get off the table on day one. Why am I waiting until this progress exam to do this? So in my practice, it's part of our initial assessment. It's part of our report of findings. It's part of our care plan, right? If we want you to get the most out of your adjustments, here's how we do it. And what we see is the practices that work best implement it as a consistent system like this. It's not based on symptoms. It's like check every patient and if it's appropriate, this is what you prescribe.

[00:27:10] What that gives you as a business is it's a little bit like having an x-ray machine in your business, right? It gives you a clinical benefit because you can obviously use your x-rays diagnostically. But there's also a financial benefit to that and it allows you to really basically to cover the cost of your marketing, right? It allows you to start to bring in an extra stream of revenue from day one. So with our orthotics, there's a $200 profit per pair that you prescribe.

[00:27:38] That really starts to add up and make a difference to your bottom line when you start prescribing or at least testing and checking every new patient for these and every existing patient. It makes a lot of financial sense as well as practice sense. Yeah, because if, as you said, you've gone through the journey over time where you used it every now and then for people that you thought would benefit, then you went to doing progress exams, then you realised that every new person that needs it.

[00:28:06] So, of course, if you make it part of your system, that's where you found the best results. That is a significant extra profit centre, if you want to look at it like that, for the business. Yeah. And it just fits in such an aligned way because it's working through the nervous system. So, you know, to use some more TRP speak, it means that your patients genuinely get better results faster. Yeah. So everybody wins, you know. Yeah.

[00:28:33] Because in the three-legged stool that we have in the remarkable practice, of course, it's adjustments in rhythm. And I know you're a chiropractor at heart. I have been for how long now? 24. 24 years. 24 years. So you're a chiropractor at heart. So you've got the adjustments in rhythm, breaking bad habits, which you mentioned one of the significant bad habits that everyone has that they do not realise is they're walking on in shoes most of the time and on artificial surfaces pretty much all the time. So there's that bad habit.

[00:29:02] And then you've got the specific exercises, but that can be this sort of thing as well. So really, it works on that leg of the stool, that part of it there, so that they are counteracting one of those stresses they have in life so they can hold their adjustments better over time. So it fits perfectly with the way that we have in the remarkable practice that we do say that practices work best. So anything else on that business side of things? What are the sort of results that you found?

[00:29:30] You said a lot of practices have found. And I know I was looking on your website. I can see all the practitioners around the globe who are using your product. So it's all over the world now, right? It is. It's growing. I mean, we're mainly Australia, New Zealand and the States, but it is growing. I've got my first call with someone from Scotland this afternoon. You know, we're talking with people in Singapore. So, yeah, absolutely. It's popping up everywhere. And it does. It just, what's nice about it too is there's really no upfront to get involved.

[00:30:01] You don't need a $20,000 scanner. You don't need an extra staff member. You don't need an extra bunch of equipment. You don't even really need extra time. You know, I would say doing the assessment and the testing in my initial consult probably takes me less than a minute. And then doing the explanation and prescription of it at the report of findings, again, probably a minute. So very, very minimal. Your only upfront costs. We encourage the practitioners to start wearing them first because you've got to walk your talk.

[00:30:28] You've got to actually experience and you'll benefit from it anyway. So very low barrier to entry, very easy to implement. There's a small amount of training. I train everybody one-on-one myself as well as having it all on video. So it's just easy. You know, like I said, I use these for years in my own practice. And when we first took over this company, we sat down and we said, what's every single thing that's a pain in the butt about this and how do we change it so that it's not? Yeah. Right.

[00:30:58] So we really tried that. Like you said, I've been in practice 24 years, right? I don't want something that's difficult. I don't want something that's complicated. I don't want something that's going to take a long time. I want something that's just, it's easy. It's fast. It really aligns with what the message I'm already communicating with the patient. And patients love it. You know, looking at break the bad habits. Well, nobody's going to break the habit of wearing shoes and walking on the floor. Right. We're all stuck. When it comes to your good habits, compliance is always challenging, right?

[00:31:26] Do these exercises, use this spinal orthotic, do this, all these things. They take time. They take effort. What's really great about these is it takes the patient about five seconds to throw them in the pair of shoes that they wear most often. And then they never even have to think of it again. You know, at most, they've got to change them from one shoe to another. So compliance is through the roof. It's really, really easy. It's not something you've got to remember to do daily. So again, patients love it. Practitioners love it.

[00:31:55] It's just, it works for everybody. Yeah. And I know the testing is fast. As you mentioned before, seeing you demonstrated on stage from a random person in the crowd, the difference it can make in not only just muscle strength, but range of movement. I think I saw one which was you did the shoulder range of motion and they were terrible. And they put them in. It was almost, it was instant. They were instant improvement. So it's the, it wouldn't be, it's not very hard at all to get people to understand how it's affecting their nervous system and their health. Is it?

[00:32:25] Yeah. That's one of the things I love, right? There's no, you don't have to sell them to anybody because people feel it, right? I can show you a report. I can tell you about it, but none of it's the same. When you feel it and you, and what happens, the most common response when we do that with patients, they laugh. They laugh. How is that even possible? All right. And the whole audience is going, ooh, that's watching fireworks. They're like, ooh, that's amazing. And so it's great because then I don't have to convince them.

[00:32:53] I just say like, here's why it works and let's get started. And away we go. It makes it a really easy conversation. Yeah. Okay. So on that, it's, it gets amazing results for people. So they hold their adjustments better and counter out one of the daily stresses everybody is having. And by the way, I know that you can use these in high heels and pretty much any type of shoes, can't you? Pretty much. Cause this is the way. Way much. So there's that side of it, the clinical side of it that you can do.

[00:33:20] But also it's a great addition to the practice as another profit center to, to drive a better business over time. So what's the best way they can get in contact with you? So obviously they can go to our website, betterbalanceauthotics.com, or they can reach out via email, which is info at betterbalanceauthotics.com. We have got like a 15 minute intro video. If you go to betterbalanceauthotics.com forward slash watch video.

[00:33:45] So the other thing I, if you go to our website, you'll see there's a weekly newsletter that I write called the foot brain connection. It's something where it's not just a piece of marketing. It's like every week, my focus is to be sharing what I'm seeing clinically, to be sharing what I'm finding in the research, the experiences I've had with patients. I really try and make it something that's valuable to everyone who reads it. And every week I get a ton of great feedback on that. People really love it and find it.

[00:34:14] They're like, this is one thing I don't make sure I don't miss. So that's another thing. If you're kind of interested just to learn a bit more and find out a little bit more about this world, jump on and just sign up to that newsletter and I'll try and keep it interesting coming your way. Yes. Yeah. And that's, I mean, amazing support for the people that you have, the people who are, who are utilizing your product and a great place for people to go to learn more about what you do as well. So, yep. Yep. So good to have you on here, Dr. Andrew.

[00:34:44] I know you are an amazing chiropractor and this is a very, very good product. It wouldn't be all over the world if it wasn't working right. And I've seen it, seen it in myself. I've seen it in my family. I've seen it everywhere. So such a great product that you have and everyone do yourself a favor and just get some. Get in contact with Dr. Andrew and get better results for patients and better income. That's always a good thing. So, pleasure to have you here and see you again in person soon. Yep. Will do. Thanks, Nathan.

[00:35:13] Please stick around for more business insights from this week's bonus interview with our remarkable success partner dedicated to helping you more successfully help more people. Enjoy. Hello, remarkable CEOs. Dr. Eric DiMartino here. I'm excited to be joining today with Jeff Van Campern from Clinic Growth Accelerator. Clinic Growth Accelerator is one of our remarkable success partners.

[00:35:38] And we always appreciate our remarkable success partners because they help us further our mission and helping docs help more people. So, welcome to the podcast, Jeff. Hey, man. I appreciate being here, Dr. Eric. It's an absolute pleasure to see you again. And this is already hard to believe we're going on year three with remarkable as a success partner. It's been an absolute privilege the entire time. Yeah, we love it, man. We appreciate all your support and all the help you give our docs. So, I'd love you to tell the audience a little about yourself and what your business does. Yeah, so I'm Jeff. I'm the co-founder of Clinic Growth Accelerator.

[00:36:08] We are an advertising agency for primarily still chiropractors, although we have dabbled into other niches even a little bit outside, including like, you know, weight loss and, you know, red light and that kind of stuff. But the bulk of our business is still within chiropractic. That's where we began. And that's how we got me to be a part of remarkable as well. So, to be clear for us, we help our clients run meta ads and we take our background in engineering and we apply those principles of data and meticulous tracking to the advertising

[00:36:37] strategies that we deploy. So, the background, the 32nd is I went to school to be an industrial engineer and grew up in Madison, Wisconsin with the school in Milwaukee. During my time in Milwaukee, I met my business partner, Nick. We were both studying engineering. And then we ultimately started businesses together somewhere in the neighborhood of like 2014 to 2015. Although we didn't really figure anything out until like 2020. I mean, we were just taking losses online for the first four years, just figuring stuff out. And then stuff worked and then we were able to actually have a system and dial it in and then scale it up.

[00:37:06] And that's ultimately how Clinic Growth Accelerator was born. And so, my favorite part of all that we do is to be able to show people that meta is like a science experiment. And it could be a very expensive experiment if you do it wrong, but it could also be a extremely lucrative experiment if you get the equation correct. So, our mission is to just ultimately allow the doctor to have an abundance of patients coming in evergreen, just people booking with their office so they don't have to go out and get it in advance and stuff like that.

[00:37:35] And then as a result, they get appointments and then we meet with the clients typically every week to begin the journey just to make sure that everyone in the partnership is doing well. Love it, man. That's great. And yeah, and just to let the audience know, full disclosure, I've been using Jeff and Clinic Growth Accelerator for my two offices for, I think we're on five years now. I think it's June. Yeah. Yeah. And so, it's been a great, great relationship and I was so glad that you came on board with TRP and get to help all our docs as well. So, I appreciate all you've done for me and for our docs. Man, it's a pleasure.

[00:38:05] Yeah, absolutely, man. And so, we're always teaching our CEOs that every business exists to solve problems, right? Our offices, we exist to solve our health challenges of our community, help people reach our goals. And so, I'd love to hear what specific problems you guys solve for chiropractors. Great question. So, the number one problem, when somebody comes to us, there's typically one of a couple things going on. The first is they're just not getting enough leads. They have a great service. They have the right staff in place. They just need more fire. They need more fuel.

[00:38:34] They need more exposure to their markets. That's probably the most common. The second most common, which maybe has even become a break-even most common over the years is that people are with a partner or they've tried marketing online and they want it to work because they still need leads, but they're extremely nervous. Or maybe they got leads from the last company, but the leads weren't qualified, right? Or they had a hard time getting those people in the door to actually turn into cash, you know? So, it's either a lead volume problem or a quality of the current lead flow problem.

[00:39:03] And so, what we'll do is come in and say, okay, well, we can look at both at the same time because you can't have one without the other. So, you know, for us, we would then come in and say, okay, like how many leads are you getting? How many do you want to get? And then start reverse engineering like what we think we should help them spend in order to start bridging the gap and then talk them through the qualification process. Qualification, I want to just talk on real quick because it's kind of an elusive thing in marketing in general, you know?

[00:39:29] Because what happens is that a lot of people just always default to just quality of leads. And I think that what happens is when people are not, they're new to the science experiment, they think that like, oh, I can just write some magical ad that's like, hey man, you know, unless you got, you know, a lot of liquid cash and a nice car and a nice house and a big family, like we're not interested in working with you, you know? That's kind of how they perceive and act like qualification really is.

[00:39:53] But when I think about qualification, I think about reverse osmosis, water filtration, you know, reverse osmosis, the dirty water goes in one filter and then it goes through the next and it goes through the next and it goes through the next. And then out comes this beautiful, clean water, right? That's like what qualification is with a funnel. It's not one step that does everything. If you only have one step, you're still left with the carbon in the water, you know? But if you actually start, you know, getting all the steps and you have a great message online, you have, maybe you have an application that asks a few questions.

[00:40:23] Then the team calls to confirm the appointment, to build rapport, make sure it makes sense to even have a conversation in the office. That is filtration. That is qualification. So it does begin with the right message to be clear. But that's the number one thing we help people understand is that you need to get a process of filtration. You don't just need leads. You need leads and a process to filter and find the good ones. 100%. You know, we, I believe the term is friction. That's right. It's like creating friction through that funnel. Cause some people are like, I just want a ton of leads.

[00:40:51] It's like, great, you can get hundreds of leads a month, but only 10% of them might show up because the other 90% weren't, weren't good leads. Or you can create some friction in there, get less leads, but as a result, actually get much higher quality new patients coming in the door. Right. Totally. And we see that across all of our clients. I mean, I've had clients head to head run the same offer and one of them were only optimizing. They're getting a ton of leads, ton of leads, and they're not even making cash on it. And then you have another client that's like, we put in this more filtration system. They are taking the deposit over the phone.

[00:41:20] They're just not really getting a ton of people in, but everyone is closing. You know what I mean? So like, they're feeling really good about it because they're like, man, these people are showing up. They're converting. My conversion rates high. My cash collected tie. Like it is a little bit of a volume game, but it's a balance of volume and filtration and also in friction. Like you said. That's why I always implore my clients to measure every step of the funnel. Don't just look at leads. Look at how much did you pay for those leads, but how many of them actually made an appointment?

[00:41:49] How many of them actually showed up to the office? How many of them came back to day two? How many of them converted? Right. So it's measuring your costs for each of those different categories of people through the funnel. And that gives you an idea of if your digital market is effective or not. That's it. That's it for sure. And you can't really like skip anything. You know, it's lead to sale. Exactly. So as CEOs, we always want a good ROI on services that we utilize. How do you guys provide a really positive ROI for docs? And then maybe you could talk about some numbers. What I love about digital marketing too, is we can really get into numbers on this.

[00:42:18] So what are some numbers you look at and what do you typically provide for your clients? I think for us, first and foremost, like, and this will help, you know, the listeners understand if, you know, a possible conversation would make sense with us is that we are particular about where a client's at in their journey. What's their current monthly revenue? What's their goal? And then also what's the money model? Now, if you're a remarkable, you know, CEO, remarkable doc listening, like good chance, you know, you already have a great money model.

[00:42:44] Remarkable does an exceptional job of teaching the plans and the packages and how to really make it profitable for the business. But if somebody has a tougher, like somebody comes to us and they're like, hey man, you know, I only do pay per visit. It's 40 bucks a visit. You forget it. You know what I mean? Like there's no, there's going to be no room for anyone to come in and help scale anything because there's no cashflow. You know what I mean? So we usually will look for a business that's doing pretty well and also has a good money model. And then we'll look at like lifetime value to customer acquisition cost ratio.

[00:43:11] Now I used to ignorantly, as I've learned more about this, I used to only say like, oh, you want to get, you know, somewhere in the neighborhood of like a five to 10 to one of lifetime value to customer acquisition ratio. And now I've started to realize that you need to get a higher ratio, the less profitable your business is. If your business is really not profitable, 10% margin, you got to get a much higher lifetime value to customer acquisition cost ratio. But if you're running, you know, anywhere from a 20 to 40% profit margin, a good healthy

[00:43:40] business service business, you know, we would like to shoot for on cash return, like a three to four to one. That means that if you spend for easy math, let's say spend five grand in an advertising program, we want you to cash collect 15 to 20, ideally in the next 30 days. That's on, that's profit, correct? Not revenue. Yes. We don't necessarily on our side, like admittedly, we don't track profit like as much, you know, but ideally like someone's getting a lifetime value. It's a customer acquisition cost of like five to one, ideally minimum.

[00:44:09] And then cash on cash. So example would be if you spend five grand and your care plans are two, we would want you to sell somewhere in the neighborhood of like eight to 10 of those so that your five grand turned into 15 to 20. Because like, the thing is, is like, this is just the reality. Most people don't know their LTV that we speak with and they certainly, and like, we can help them find the customer acquisition costs, but transparently we don't get into like the deep profitability of their business, you know, in terms of margin and expenses and that kind of stuff.

[00:44:38] So the most of the time people come to us, they're like, Hey, I want to be able to get, if I spend three with you, four with you, I want to four X that money, or I want to five X that money. So as long as it's within like that three to five X, we're confident we can deliver on that. Once I had a guy come to me one time, he's like, bet I need to get at least 15 X for to make sense of this. And I was like, I can't promise that. So I think you have to be disciplined in your own business and knowing your customer acquisition costs or LTV and what ratio you need.

[00:45:04] We usually were looking at like at least a three to four to one, just cash invested the cash return. That makes sense. And plus you guys aren't the ones in the office closing people either. No, your job is to drive them in the front door, but you know, LTV and CAC is all determined by how well we actually do our conversion processes in the office. For sure. Absolutely. And I highly encourage, you know, everybody to know the numbers as granular as you guys teach, you know, you know, your LTV, know your CAC, know what your target should be.

[00:45:32] You know, for us, it's like a client's willing to share their profitability and that conversation does occur. Like we can help them do the math. You know what I mean? Just a lot of people sometimes show up and they just haven't done the math yet. Yep. So any new services you guys expect to offer in the future? Yeah. There's a couple of things that works for us. We always look at like, okay, what are the other problems that we can help like solve? So ARPA is this actually creates problems. If you think about it, someone gets someone that needs leads, they get leads. Now they have a problem on the phones. They got to make calls.

[00:45:59] So one of the things I've seen over the years is that one of the biggest constraints in our clients is just their ability to have good lead follow-up on the phones. So for us, we've always wondered like, what would that process look like if we like were to control more of that? So we've built out like a beta version of an AI bot. And I would say it's 80% awesome. The other 20%, it needs a little bit of work still. So that's in the works because right now, like a lot of clients lose because they have

[00:46:27] poor speed to lead, which I think matters more now than ever just because of competition and the Amazon of the world, you know? So the bot helps with speed to lead. So we're working on that. Another problem that we create with docs, maybe not even a problem, but an opportunity is if you get, if you run ads, I mean like even our work together, you know, we probably generated between your offices like four or 5,000 leads, you know? So like there's a huge opportunity to do consistent email marketing to that list.

[00:46:54] Because the thing is, is like half the awesomeness of direct response is building a list. Because like for me at CGA, like we'll email our lists, you know, six, seven times a week. And like I get, you know, only a couple of deals a month from that, but the cost of the return or the return on it is insane. So what you're doing is that, you know, people are so short term when they're like, oh, I got a lead, they got to close them now. But I think more of like, okay, if we get a lead and we don't close them, we're going to nurture them so much that when they're ready to make the change, they think of us.

[00:47:21] So we're working on an email marketing service just because a lot of our clients do have big lists. And then we'll also be implementing likely just some Google AI search ads as well. I think we have to be not only on Google, but also on the AI search as well. Okay. Love that. There's a lot of services like yours out there. What, why should the listeners choose you guys? What kind of sets you apart? That's a good question. You know, until we have a first discussion, I'm not even sure they should to be clear right away.

[00:47:46] But if you did, the main reason that our clients, I feel like end up choosing us possibly over somebody else would be the meticulousness on the data. So more so just doing those leaky reviews, having the Excel sheets, having our data clearly in front of you to say, here's how many leads you got. Here's how I've been booked appointments. And then being able to take feedback from the client and say, okay, how many people showed up and converted? So I think that like full vision and full vantage point of the entire funnel is one of the

[00:48:15] biggest differentiators, I would say, because a lot of people, like they just, they run ads and they kind of just hope for the best. I'm a big believer that if you run ads, you should be able to watch the bottleneck change. You know, like the bottleneck should not be in one, one part of the funnel month over month, week over week. Like we should see it kind of moving around. First you need leads, then it's the sales, then it's the cash collected, you know? So I think people come to us and they see that, okay, like these guys are going to give me my fairest shot at meta and getting the science experiment right, because they're going to be

[00:48:44] so meticulous in what they track that it's going to be easy to identify where the constraint is and take the right actions to overcome that. So I think the data, and then also people like the accountability as much as people don't, as much as people like, you know, maybe you think they might have a gripe of getting on the call with us. I think by the time they're done with the call and they have clarity on what's going on, they feel good, or at least they know what needs to be course corrected. So it just keeps everybody in the game. So what's the next step for our listeners to connect with you guys and learn more about how you may be able to help them? Yeah, good question. A couple of ways.

[00:49:13] I'm happy to provide like a link if it's necessary too, for you guys, or it would be helpful rather. And then otherwise you can just go to our website. It's just www.growyourclinic.com. So that's growyourclinic.com. You can just book in with there. Typically, no matter who books in with us, we'll ask you where you found us. So if you found us from the show, we'll know that. And otherwise, again, I'm happy to provide a link. And then my email is quite literally just jeff at growyourclinic.com. Well, thanks again for being a longtime success partner.

[00:49:43] We appreciate all your support and all you guys do for us. So remember, Remarkable CEOs, remember to tune in each week to our Remarkable CEO podcast. Hope everyone has a blessed week and I'll see you guys next week. Thanks for listening to this episode of the Remarkable CEO podcast. Remember, what the world needs now is chiropractic. And what chiropractic needs now is more successful chiropractors. If you like this podcast, please subscribe, share with a friend, and leave us a review.

[00:50:13] And if you'd like to connect with us personally, direct message us on Facebook, LinkedIn, or Instagram. Now go and be remarkable.